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Soy and Cholesterol Reduction: Clinical Experience¹

Cesare R. Sirtori^2,*, Maria R. Lovati, Cristina Manzoni, Marco Monetti^**, Franco Pazzucconi and Ennio Gatti

^* Institute of Pharmacological Sciences ^* Center E. Grossi Paoletti, University of Milano ^** Hospital Regina Elena, Pediatrics Division, Milano Department of Nutrition, Niguarda Hospital, Milano

A role of vegetable proteins in reducing coronary artery disease risk was postulated as long ago as 1909 in Russia by Ignatowski. The protein hypothesis of atherosclerosis was pursued by many investigators, who studied the possible role of animal vs. vegetable protein in modifying concentrations of plasma lipids and thus cardiovascular disease risk. Over the past 20 y, our research group has examined the potential of a diet based on vegetable protein (in most cases, textured vegetable protein, or TVP) to modify plasma lipid concentrations. Textured products allow administration of a large percentage of protein (up to 50–60% in the product) and are available in a variety of food items. We studied >1000 patients. An extensive review of the literature indicates that similar findings have been reported by others when administering TVP or TVP-like items to subjects with well-characterized hypercholesterolemia (Fredrickson type II). Data are less consistent for treatment of patients with marginal hypercholesterolemia or hypercholesterolemia already corrected by a standard diet before administration of soy products. The TVP diet, is, however, effective when normolipidemic individuals are made hypercholesterolemic by dietary cholesterol administration. These and other findings suggest that, in man, similar to experimental animals, soy protein may in some way up-regulate LDL receptors depressed by hypercholesterolemia or by dietary cholesterol administration.

KEY WORDS: • soy protein diet • TVP • hypercholesterolemia • LDL receptors • nephrotic syndrome

¹ Presented at the First International Symposium on the Role of Soy in Preventing and Treating Chronic Disease, held in Mesa, AZ, February 20–23, 1994. The symposium was sponsored by Protein Technologies International, the soybean growers from Nebraska, Indiana, and Iowa and the United Soybean Board. Guest editors for this symposium were Mark Messina, 1543 Lincoln Street, Port Townsend, WA 98368, and John W. Erdman, Jr., Division of Nutritional Sciences, University of Illinois, Urbana, IL 61801-3852.

² To whom correspondence should be addressed: Institute of Pharmacological Sciences, University of Milano, Via Balzaretti 9, 20133 Milano